This anterior capsular plaque makes the capsulorhexis creation more challenging. The capsule will not tear predictably in the region of this opacity and even the stellate arms have fibrotic changes which will impede the capsulorhexis tear.
The solution is to make a larger capsulorhexis and fully encompass this opacity. In this case, the anterior capsule flap then splits and that must be addressed to successfully complete the capsulorhexis.
Click below to learn how to deal with this challenge and complete the capsulorhexis:
I had a similar case recently but plaque was more central and it even looked like the anterior capsule in the area had been violated. I used the femtosecond laser and it made a beautiful rhexis around this defect. I’ve also done the rhexis manually on other cases similar to your technique. Thanks for the great videos.
Thanks Jackie! If you have a good video of this (or any other interesting case), please send it so we can feature it in CataractCoach